H1N1 : causing a neurological complication in Indian kids…..

MUMBAI : A 10-month-old infant from Goregaon, Mumbai, has lost his sense of recognition and is unable to identify familiar faces, including his parents’, following a neurological complication caused by influenza H1N1. The extensive brain impairment in the baby has sent warning bells among clinicians that the viral infection can go beyond the respiratory system.
Over the last one month paediatric neurologists have treated at least five to six confirmed cases of H1N1 in children, who have presented with neurological complications primarily, instead of the usual fever, cough and throat infection. Two of these children continue to be hospitalised. The neuro experts have strongly advised physicians to think of H1N1 while treating unexplained seizures or inflammation in the brain. All the babies required ventilation and ICU care.
The Goregaon infant was brought to the Surya Child Care Hospital in Santacruz about three weeks ago in an extremely critical condition. The baby was unconscious, breathing with difficulty and almost slipping into coma. While a cerebrospinal fluid (CSF) test ruled out dengue and other infections such as herpes, the MRI scan was the red flag.
“It showed bleeding in the thalamus, an important region that relays sensory and motor signals. We diagnosed the baby with acute necrotising encephalopathy of childhood (ANEC), a kind of brain damage, which can be caused by viral infections. In this case, it was H1N1. Viral infections have been associated with ANEC but they are extremely rare,” said paediatric neurologist Dr Omkar Hajirnis, who consults at Surya Hospital.
He said that the baby has been moved out of ICU recently but he has lost his sense of recognition. “ANEC is also known to cause loss of vision which we are yet to confirm in this child,” he said, adding that he himself has treated four children with brain involvement.

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